Background: Non-communicable diseases are the leading causes of death, largely due to the last century's often-unhealthy lifestyles. Family medicine (FM) and other physicians can improve patients' lifestyle behaviors, yet FM residency programs in Israel and other countries do not uniformly deliver lifestyle medicine (LM) training. The readiness of FM residents to counsel on lifestyle issues is not known. The purpose of this study is to assess knowledge, attitudes, and confidence levels of senior Israeli FM residents regarding LM counseling, and to evaluate the influence of LM training and personal health behaviors on residents' LM knowledge, attitudes, and confidence. Methods: From May to June 2017, we surveyed all senior Israeli FM residents regarding their knowledge, attitudes, confidence, and personal health behaviors. We compared health behaviors, attitudes, and confidence in counselling between: 1) trained residents vs. untrained residents; 2) physically active residents vs. not physically active residents; 3) residents with a BMI < 25 vs. those with a BMI > 25; and 4) residents who eat a Mediterranean diet vs. those who do not. Results: A total of 169 senior Israeli FM residents were surveyed, and 143 completed the survey, a response rate of 84.6%. Senior FM residents said they considered LM counseling to be an integral part of their role and an effective tool by which to improve a patient's health. Yet, their knowledge of LM and their confidence in delivering LM counseling are low. Compared with untrained residents (n = 84), LM-trained residents (n = 55) had higher knowledge scores (30.9% vs. 13.1%, p = 0.016) and were more confident in their ability to impact their patients' behaviors (53.7% vs. 34.5%, p = 0.004). Residents' positive personal health behaviors correlated with a higher level of confidence to provide LM counseling. Conclusions: FM physicians can play a key role in the management of patients with chronic diseases. Israeli FM residents consider counseling patients about a healthy lifestyle to be an integral part of their work, but do not feel well prepared to do so. Dedicated LM training and resident's personal health promotion may improve critically important levels of LM counseling and patient outcomes, and this training should therefore become a higher priority.
Bibliographical noteFunding Information:
The research was funded by the Israeli Association of Family Physicians which supported the research assistants and statistician time with EF’s efforts supported by the Canada Research Chair in Preventive Medicine and Population Health, and the Annenberg Physician Training Program in Addictive Disease.
The authors thank the previous Chairman of the Israeli Association of Family Physicians, Prof. Shlomo Vinker, for his ongoing support, and Tamar Freud, PhD, Research Manager, and Ilona Kolushov from the Siaal Research Center, for FM and primary care-related contributions and for performing the statistical analysis. We thank Deb Holmes for her editing assistance, and the UBC Canada Research Chair program and Annenberg Physician Training Program for their support of this research through Dr. Frank.
© 2020 The Author(s).
- Educational program
- Family medicine
- Health behavior
- Lifestyle medicine
- Lifestyle medicine course